Doak G J, Li G, Hall R I, Sullivan J A
Department of Anaesthesia, Dalhousie University, Halifax, NS, Canada.
Can J Anaesth. 1993 Feb;40(2):176-82. doi: 10.1007/BF03011317.
This study in dogs determined the effect of systemic cooling and arterial hypocarbia during cardiopulmonary bypass (CPB) on the requirements for enflurane anaesthesia (MAC) before and after CPB. Twelve mongrel dogs were each anaesthetized with enflurane in oxygen on two separate occasions. End-tidal enflurane concentration was measured with a Puritan-Bennett Anaesthesia Agent Monitor. Using the tail-clamp method, MAC was determined twice with a one-hour interval between measurements (MAC 1 and MAC 2). Partial CPB was then initiated using femoral arterio-venous cannulation and maintained for one hour. Following separation from CPB, MAC was again determined twice with a one hour interval between measurements (MAC 3 and MAC 4). Dogs were randomly assigned according to PaCO2 management during CPB (low, 17.6 +/- 8.6 mmHg vs high, 38.9 +/- 11.5 mmHg), and then subjected to two experimental conditions. The first experiment on each dog was undertaken using normothermia during CPB (warm, 35-37 degrees C) while the second experiment (at least two weeks later) was conducted using hypothermia during CPB (cold, 30 degrees C). Analysis of the data, using ANOVA for repeated measures, revealed MAC 3 (1.95 +/- 0.33%, post-CPB) to be reduced when compared with MAC 1 (2.18 +/- 0.28%, P < 0.01) or MAC 2 (2.10 +/- 0.22%, P < 0.01), determined before CPB. Multivariate repeated measures analysis revealed no independent effects of hypothermia or arterial hypocarbia during CPB, on MAC reduction. By the time of the second experiment in each dog (two weeks later), MAC had returned to baseline levels.(ABSTRACT TRUNCATED AT 250 WORDS)
这项针对犬类的研究确定了体外循环(CPB)期间全身降温及动脉血低碳酸血症对CPB前后安氟醚麻醉(MAC)需求的影响。12只杂种犬在两个不同时段分别用氧气和安氟醚进行麻醉。采用Puritan-Bennett麻醉气体监测仪测量呼气末安氟醚浓度。使用夹尾法,每隔1小时测量两次MAC(MAC 1和MAC 2)。然后采用股动静脉插管开始部分CPB,并维持1小时。脱离CPB后,再次每隔1小时测量两次MAC(MAC 3和MAC 4)。根据CPB期间的PaCO2管理情况(低,17.6±8.6 mmHg对比高,38.9±11.5 mmHg)将犬随机分组,然后使其接受两种实验条件。对每只犬进行的第一项实验是在CPB期间采用正常体温(温暖,35 - 37摄氏度),而第二项实验(至少两周后)是在CPB期间采用低温(寒冷,30摄氏度)。使用重复测量方差分析对数据进行分析,结果显示与CPB前测定的MAC 1(2.18±0.28%)或MAC 2(2.10±0.22%)相比,MAC 3(1.95±0.33%,CPB后)降低(P < 0.01)。多变量重复测量分析显示CPB期间低温或动脉血低碳酸血症对MAC降低无独立影响。到每只犬进行第二项实验时(两周后),MAC已恢复至基线水平。(摘要截短为250字)